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What Men Need to Know About Testosterone Therapy

Did you know that after the age of 35, Testosterone levels begin dropping an average of 2% a year for men? This can result in a slow decline of mental cognition, loss of muscle retention, depressed mood, decreased energy levels and sexual dissatisfaction. You may have heard about Testosterone replacement therapy, but what are the benefits versus risks, how does it work, and who should you trust to perform this type of treatment? We are here to answer all of those concerns!

What are the benefits of Testosterone replacement therapy? Every man is different and every treatment plan varies, but most men report increased energy, sex drive, and muscle mass and increased bone density. It can have a great impact on quality of workouts, ability to gain muscle, decreased fat, particularly around the mid-section, and controlled insulin levels. Many also report a positive change in mood and happiness.

What are the risks or complications of Testosterone therapy? Like the benefits, the risks can vary, but the primary risks include erythropoiesis (production of red blood cells) and elevated PSA (Prostate-specific antigen) levels, which raises concern for prostate health. At Vitality Health we check these levels frequently as well as adding in an EKG (electrocardiogram) to test the electrical activity of your heart. There are countless studies that support Testosterone as a very safe, effective medication.

What qualifications should I look for in a Testosterone therapy provider? Always seek advice and treatment from a certified, trained provider who has experience specifically with Testosterone replacement therapy. At Vitality Health only board-certified physicians, physician assistants, or nurse practitioners see patients for men’s health.

Can I go to my family physician for Testosterone replacement therapy? You can certainly go to your family physician to ask about Testosterone. It is important, however, that whoever is seeing you or administering this medication is familiar with the various aspects of Testosterone insufficiency, the medications involved, and the clinical management. Family physicians will often schedule patients every few weeks for testosterone replacement therapy, which causes patients testosterone levels to have lots of highs and lows. We do weekly injections at Vitality Health, this gives our patients the steady, healthy level of Testosterone Replacement Therapy they need to feel great.

What labs do you check and how often do you check them? We check a full lab panel including CBC (blood counts), CMP (liver, kidneys, etc.), Testosterone levels, and PSA. We check labs at day 1, month 3, and 6 months. We also do an EKG to screen for heart disease.

What types of Testosterone replacement therapy are there? Testosterone boosters come in the form of topical applications, injectables, implanted pellets and other medications that affect hormone levels. These treatments can help optimize a healthy, satisfying quality of life. Before beginning treatment, you’ll meet with your provider to determine what form of treatment is best for your situation and lifestyle.

  • Topical applications: Topical applications, such as gels or patches, are absorbed through the skin to deliver the amount of testosterone prescribed by your doctor

  • Injectables: Testosterone is injected directly into the muscles, allowing your body to absorb the testosterone into your bloodstream

  • Implanted pellets and medications: Testosterone is implanted under the soft tissues of your skin to slowly absorb into your body

What form of Testosterone therapy will I be prescribed? At Vitality Health we use only injection Testosterone or surgically placed pellets, as these give the most accurate, reliable dose. Pills, intranasal, patches and gels are very unpredictable since you really don’t know what dose is being absorbed, which raises risks and adds in too many variables.

If my Testosterone level gets too high, how will I know and what can we do? This is a common occurrence and it is one of the reasons why it is so important to be treated by a trained clinician to adjust these levels. Since we measure your labs at day 1, month 3, and quarterly, we are able to safely and effectively adjust your levels and ensure you get the proper amount of hormone. We prescribe Anastrazole, which blocks the conversion of excess Testosterone to estradiol, a form of estrogen. If this is not prescribed, patients may show signs of excess estrogen such as weight gain, water retention, moodiness, and emotional liability.

Are there situations Testosterone replacement therapy should not be performed for the health of the patient? Yes, and this is why we perform several tests before starting any therapy to ensure it is in the best interest of the patient. Prostate cancer is an absolute contraindication as well as elevated PSA and/or elevated Hematocrit levels.

Does Testosterone therapy cause heart disease? In 2003 the Institute of Medicine reported that there was no association with Testosterone therapy and heart disease. In fact, since then, there is mounting evidence that the exact opposite is true. T has such a great affect on mood, energy, increased muscle, decreased fat in the midsection, etc. which may actually improve heart health. It is now being researched as cardio protective.

Does Testosterone therapy cause Prostate Cancer? This is a common misconception. The answer is NO, Testosterone replacement therapy does not cause cancer. If someone already has cancerous cells, Testosterone therapy can increase the rate of growth, but it will not cause cancer to develop. This is why screening labs, specifically a Prostate Specific Antigen level, are vital before you being Testosterone treatment. It’s also important to tell your provider if Prostate cancer runs in your family.

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